Dynamic Pathology of the Heart, A Personal Odyssey

As a student of cardiovascular pathology in humans and animals for 35 yr, I am impressed with the new knowledge of the molecular biology, biochemistry, physiology and pharmacology of the heart in health and disease. All of this information creates a dynamic setting for the interpretation of structural findings. Before the advent of open-heart surgery and the cardiac biopsy, pathologists had to rely largely on accumulated autopsy data. Today, a great deal of empiric dogma has given way to good science. In 1962, I met Professor FZ Meerson in his laboratory in the Institute of Normal and Abnormal Physiology, Moscow. He had just characterized the biochemical events leading to myocardial degeneration and cell death in animals with acute aortic constriction (19). His pioneering work provided the basis for understanding the sequential changes in myocytes in the failing heart. These cellular events corresponded to the astute clinical observations made by Osler in 1886. Meerson was enthusiastic about the potential of electron microscopy. However, he was convinced that when we had the techniques to identify and localize in the cardiac muscle cell the key chemical entities associated with changing function, we would rapidly understand pathogenesis leading to new therapies. Today, almost 30 yr later, Meerson's prophetic insights have become a reality. I had assured Meerson that when the tools were available to study the dynamic pathology of the heart, pathologists would lead the way. Dynamic pathology of the heart is a concept since the words are somewhat contradictory. The term serves as a symbol for a state of mind which refuses to interpret cardiovascular pathology in static, histologic words.(ABSTRACT TRUNCATED AT 250 WORDS)